CHENNAI: With exorbitant costs making cancer medicines increasingly inaccessible to most Indian households, Tamil Nadu's public drug procurement model facilitates a credible pathway to make life-saving treatment affordable across the country.
A study published in The Lancet Regional Health – Southeast Asia has identified Tamil Nadu's centralised medicine purchasing system as India's most effective response to the soaring costs in cancer care.
The study, authored by Maulik Chokshi and Oshia Garg, examines the structural reasons behind India's crippling cancer treatment costs.
It finds that medicines alone account for over 60 per cent of cancer patients' out-of-pocket expenditure, making cancer the leading cause of catastrophic health spending among Indian households.
Placing Tamil Nadu in sharp contrast against this national crisis, the study highlights the Tamil Nadu Medical Services Corporation (TNMSC) as the country's most successful example of strategic public procurement, noting that its centralised tendering and bulk-purchase system has reduced drug procurement prices by about 30% while ensuring consistent availability of essential medicines in government hospitals.
"Fragmented procurement and weak bargaining power have allowed oncology drug prices to escalate unchecked in India," the authors note, adding that Tamil Nadu's pooled purchasing approach demonstrates how coordinated buying can deliver affordability without compromise in quality or supply stability.
The study observes that lower procurement prices in Tamil Nadu's public health system have reduced out-of-pocket spending for patients, a critical safeguard in a country where cancer treatment often forces families into debt, distress financing or treatment discontinuation.
It further notes that while statutory price controls exist at the national level, they have limited impact on high-cost cancer drugs, particularly newer therapies such as immunotherapy, which can cost between Rs 2 lakh and Rs 3 lakh a month.
In such cases, the absence of strong public purchasing mechanisms leaves patients exposed to market-driven pricing.
Tamil Nadu's procurement architecture, the authors argue, offers a ready-made institutional framework to address this gap if applied systematically to oncology medicines.
They point out that several states, including Kerala, Rajasthan, Odisha, Andhra Pradesh, Delhi and Assam, have already adopted the TNMSC model for essential drugs, underlining its scalability and administrative feasibility.
However, the study stresses that its application to cancer medicines remains limited and requires urgent expansion, especially as India faces a rising cancer burden and widening inequities in access to treatment.
Beyond pooled procurement, the authors recommend complementing Tamil Nadu's model with value-based pricing for high-cost, patented cancer therapies, linking prices to proven clinical benefit.
Such a dual approach, they argue, would allow India to contain costs while still encouraging meaningful pharmaceutical innovation.
International agencies have previously recognised Tamil Nadu's procurement system as a global best practice.
The Lancet study builds on that recognition, positioning the State not merely as a welfare provider but as a policy innovator whose systems could reshape India's cancer care landscape.